Brittle Nails

Nail brittleness causes several clinical symptoms including splitting, softening, lamellar exfoliation and onychorrhexis. Brittle nails are a common complaint. It is often an idiopathic condition, but can also be a symptom of a large number of dermatological nail disorders. Although brittle nails have been linked with many internal diseases, the high frequency of nail fragility in the general population makes it difficult to prove the validity of any such association. Environmental and occupational factors that produce a progressive dehydration of the nail plate play an important part in the development of idiopathic nail brittleness. The lipid content of the nail is influenced by sexual hormones and decreases after menopause. This explains the high prevalence of brittle nails in postmenopausal women.

Management of brittle nails requires preventive and protective measures to avoid nail plate dehydration. Affected individuals should wear cotton gloves under rubber gloves during household tasks, avoid repeated immersion of the hands in soap and water, and keep their nails short. Nail varnishes may be protective, but the use of nail varnish remover should be limited since it exacerbates brittleness. Local therapies are useful in the treatment of nail brittleness. Application of a petroleum jelly preparation on wet nails at bedtime helps to retain the moisture in the nail plate. Frequent topical application of preparations containing hydrophilic substances such as phospholipids, hyaluronic acid, alpha-hydroxy acids and proteoglycans may favour nail plate rehydration.

Nail wrapping limited to the distal portion of the nail may afford protection and camouflage in recalcitrant fragility of the nail keratin. Oral treatment with biotin 2.5 mg per day for several months or even all year round can be useful as it may improve the synthesis of the lipid molecules that produce binding between nail plate corneocytes.

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